The number of Colorado hospitals receiving an "A" grade for patient safety nearly doubled in the past six months, from seven to 13 -- with Lafayette's Exempla Good Samaritan Medical Center moving up to that top tier of facilities.

In Boulder County, Boulder Community Hospital raised its grade from "C" to "B," while Longmont United Hospital and Louisville's Centura-Avista Adventist Hospital held steady with "C" grades.

The Washington-based Leapfrog Group sets the grades nationwide and publicizes them to reduce the nearly 400 lives lost every day in U.S. hospitals due to preventable errors. These include hospital-borne infections and giving the patient the wrong medication or the wrong blood. Hospitals are ranked on their rates of such problems as well as related factors like staffing levels and prevention practices.

One-third of the 39 ranked Colorado hospitals received an "A" grade in a just-released report, while states like Maine and Massachusetts, with strong hospital safety programs, saw 80 percent or more receiving the top grade.

"Leapfrog is unbiased in telling the whole truth about how hospitals are doing, no matter how much discomfort that causes many of them. Consumers deserve 'A' hospitals and someday we may see all hospitals earning 'A's.' However, we are not there yet," said Keith Reissaus, board chair of The Leapfrog Group, in a media release.

Another 11 hospitals in Colorado received a grade of "B," and 15 received a "C" grade. The last included Exempla Lutheran in Wheat Ridge, which boosted its grade from a "pending" or failing grade last June.

Colorado had none of the 147 hospitals nationwide receiving failing grades in this round of rankings.

Rich Sheehan, a spokesman for BCH, said Boulder Community's improvement largely was due to providing Leapfrog with more detailed information.

Boulder and Longmont have newly introduced Computerized Provider Order Entry systems and Avista Adventist will be adding one in February.

"The state of the art in CPOE is evolving at a very fast pace," said Avista Adventist CEO John Sackett. "If you implement it too soon and it doesn't work well, you can actually get worse results. We wanted to wait until it was a little more defined."

Within a year, Sackett said, his hospital would probably rise to an "A." But, he noted, patients needed to go beyond a letter grade and look at the information it's based on, before deciding how comfortable they feel with a particular hospital.

Other hospitals and the Colorado Hospital Association agreed, encouraging patients to research a hospital's safety information using multiple sources, as well as checking with their physician, family and websites such as the CHA's own report card at cohospitalquality.org.

"We absolutely want to be an 'A' in everything," Sackett said. "But we also think we provide better care than a 'C' grade suggests. If someone looks at that letter grade alone, it could be totally misleading."

Two of the improvements that the report weights heavily -- electronic orders from doctors and nurses instead of handwritten ones, and the use of physicians who specialize in intensive care -- have both been upgraded Longmont Untied Hospital in the time since Leapfrog gathered its data.

"The improvements we made in 2012 probably won't even be in their reports until 2014," said Karen Logan of Longmont United Hospital. "It's a really long process."

The Colorado Hospital Association had objected to the Leapfrog study six months ago, but says changes have been made that no longer penalize certain hospitals for failing to report certain safety data. CHA also suggested patients seek personal references for quality hospitals, and check other websites with quality data, including Medicare's Hospital Comparison, the state's data on infections and CHA's own Colorado Hospital Report Card.

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